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The Journey into Functional Medicine

The Definitive Series on Longevity and Anti-Aging: Part I

Lisa Cassileth MD, FACS laughing with a patient in her office

Ok, it’s time to get real. There’s more to medicine than I was taught.

It’s with a combination of a quest for knowledge, mixed with a little anger and embarrassment that I started a journey into functional medicine.

My first exposure to functional medicine was with sources that were possibly unreliable. First, my hairdresser told me that if she didn’t have her NAD IV drip, she could not function. I thought, “What is an NAD infusion?” This is not taught at Penn Medicine! Of course, I “researched” it (ok, I used Google like everyone else), and I checked the NIH PubMed sites, which have all the abstracts for the published articles.

There were a few good studies about NAD treatment, but nothing that could make me get behind the NAD infusion with certainty; NAD supplementation showed a “favorable outcome on several age-related disorders associated with the accumulation of chronic oxidative stress, inflammation, and impaired mitochondrial function.” What?!?

Next was my personal trainer, who seemed to know everything about growth hormone secretagogues; I had to Google this as well (CJC/Ipamorelin, anyone?).

Finally, it came to a head when a close family member had a health problem that could not be solved.

This 50-year-old-in-perfect-health had a peripheral neuropathy and would go to sleep in pain, often with the electrical fire sensations keeping her up nightly. Her feet were numb, and it was creeping up her leg, worsening every month.

She went to all my favorite, highly well-trained doctors. They ruled out B12 deficiency, Lyme disease, diabetes, pinched nerve or spinal cord, to name a few. There was some bad advice, like don’t go skiing or you could become paralyzed. And do IV penicillin infusions for a year through a port, even though you are Lyme Ag negative. But nothing that helped.

She also had an extensive, multi-day visit to the renowned Mayo Clinic, who told her that her neuropathy was idiopathic and that she would eventually be unable to feel her legs and likely her hands and arms.

We used to joke in med school that “idiopathic” meant “the idiots don’t know what caused it.” It wasn’t fun to have someone I cared about receiving this news!

On her own, she found a functional medicine doctor who used to be an orthopedic surgeon. He put her on peptides and supplements. Here’s the big news: She got better. A lot better. Her sensation returned, her pain stopped, and she got better. Great news, but what the hell? Why didn’t the Mayo Clinic recommend that?

I met with her doctor, a knowledgeable and eccentric, extremely buff guy named William Seeds, who many consider a modern peptide guru. He was extremely hard to understand, given that he spoke in a biochemical language not used today by doctors. He talked about MTOR, Sirtuins, telomeres, and mitochondria.

Luckily, my dad is a biochemical geneticist MD/PhD, so I also got to run a lot of this stuff by him, which he confirmed was legit. I suddenly realized I had a lot to learn.

I started taking functional medicine classes. It felt like I was going back to med school, but it wasn’t just memorizing diseases and treatments; it was about understanding the metabolic pathways themselves. I relearned how the immune system works, how the body reduces free radicals, and how the cells repair their DNA. I found a wealth of knowledge behind everything that works, from intermittent fasting to resveratrol.

I brought the knowledge back to my patients, and after trying the recommended peri-operative peptides by Dr. Seeds on myself (no effect whatsoever, maybe my allergies cleared up?), I consented and tried it on my patients, starting with my patients having revision surgery (from surgery with a prior surgeon).

I used the most naturally occurring, low side effects “stack” (two or more peptides combined), and the response I got was overwhelming! Patients loved it. Most felt better after this surgery and recovered much faster than after any other surgery. Many felt better while on the peptide stack than off and insisted on staying on for an extra week or two.

The most common question I received was, what else can I do? And so began my dive down the rabbit hole. I’m bringing you, curious reader, down the hole with me. The goal is to figure out what works, separate the hype from the reliable, and optimize ourselves.

I love the empowerment of biohacking, but I don’t particularly like surgical complications, and I don’t like getting old. And here’s the realization for you doctors: if you don’t know about this stuff, you aren’t fully treating your patients. Here we go!

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